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Academic achievement in children with chronic kidney disease: a report from the CKiD cohort

Pediatric Nephrology volume 34, pages 689–696 (2019)Cite this article

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Abstract

Background

There are limited data to describe academic achievement outcomes for children with mild to moderate pediatric chronic kidney disease (CKD). The objective of this study was to describe the prevalence of low academic achievement in patients with mild to moderate CKD.

Methods

Wechsler Individual Achievement Test, Second Edition, Abbreviated (WIAT-II-A) data were collected at entry into the Chronic Kidney Disease in Children (CKiD) study. Achievement in basic reading, spelling, mathematics, and total achievement was evaluated with a focus on the effects of comorbid CKD-related variables, neurocognitive, and school-based characteristics on academic achievement.

Results

WIAT-II-A data were available for 319 children in the CKiD cohort. Low total academic achievement was present in 34% percent of the sample. There was no significant effect of CKD-related medical variables on academic achievement. Mathematics had the lowest distribution of achievement scores. In univariate models, low achievement was significantly related to days of missed school (p = 0.006) and presence of individualized education plan (p < 0.0001).

Conclusions

Low academic achievement was seen in over one-third of children with CKD, with the most difficulty observed in the domain of mathematics. Providers and educators should monitor for academic difficulties in this population in order to facilitate early educational assistance and promote positive educational outcomes.

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References

  1. Wong CJ, Moxey-Mims M, Jerry-Fluker J, Warady BA, Furth SL (2012) CKiD (CKD in children) prospective cohort study: a review of current findings. Am J Kidney Dis 60:1002–1011

    Article  PubMed  PubMed Central  Google Scholar 

  2. Mendley SR, Matheson MB, Shinnar S, Lande MB, Gerson AC, Butler RW, Warady BA, Furth SL, Hooper SR (2015) Duration of chronic kidney disease reduces attention and executive function in pediatric patients. Kidney Int 87:800–806

    Article  PubMed  Google Scholar 

  3. Johnson RJ, Matheson MM, Gerson AC, Mendle ySR, Shinnar S, Lande MB, Kogan A, Harshman LA, Gipson DS, Warady BA, Furth SL, Hooper SR (2015) Emotional-behavioral functioning of children enrolled in the Chronic Kidney Disease in Children (CKiD) cohort study. American Society of Nephrology Kidney Week, San Diego

    Google Scholar 

  4. Hooper SR, Gerson AC, Butler RW, Gipson DS, Mendley SR, Lande MB, Shinnar S, Wentz A, Matheson M, Cox C, Furth SL, Warady BA (2011) Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease. Clin J Am Soc Nephrol 6:1824–1830

    Article  PubMed  PubMed Central  Google Scholar 

  5. Duquette PJ, Hooper SR, Wetherington CE, Icard PF, Gipson DS (2007) Brief report: intellectual and academic functioning in pediatric chronic kidney disease. J Pediatr Psychol 32:1011–1017

    Article  PubMed  Google Scholar 

  6. Furth SL, Cole SR, Moxey-Mims M, Kaskel F, Mak R, Schwartz G, Wong C, Munoz A, Warady BA (2006) Design and methods of the Chronic Kidney Disease in Children (CKiD) prospective cohort study. Clin J Am Soc Nephrol 1:1006–1015

    Article  PubMed  PubMed Central  Google Scholar 

  7. Schwartz GJ, Schneider MF, Maier PS, Moxey-Mims M, Dharnidharka VR, Warady BA, Furth SL, Munoz A (2012) Improved equations estimating GFR in children with chronic kidney disease using an immunonephelometric determination of cystatin C. Kidney Int 82:445–453

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Kliger AS, Foley RN, Goldfarb DS, Goldstein SL, Johansen K, Singh A, Szczech L (2013) KDOQI US commentary on the 2012 KDIGO Clinical Practice Guideline for Anemia in CKD. Am J Kidney Dis 62:849–859

    Article  PubMed  Google Scholar 

  9. Flynn JT, Mitsnefes M, Pierce C, Cole SR, Parekh RS, Furth SL, Warady BA, Chronic Kidney Disease in Children Study G (2008) Blood pressure in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children study. Hypertension 52:631–637

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Rasbury WC, Fennell RS 3rd, Morris MK (1983) Cognitive functioning of children with end-stage renal disease before and after successful transplantation. J Pediatr 102:589–592

    Article  PubMed  CAS  Google Scholar 

  11. Brouhard BH, Donaldson LA, Lawry KW, McGowan KR, Drotar D, Davis I, Rose S, Cohn RA, Tejani A (2000) Cognitive functioning in children on dialysis and post-transplantation. Pediatr Transplant 4:261–267

    Article  PubMed  CAS  Google Scholar 

  12. Groothoff JW, Grootenhuis M, Dommerholt A, Gruppen MP, Offringa M, Heymans HS (2002) Impaired cognition and schooling in adults with end stage renal disease since childhood. Arch Dis Child 87:380–385

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Thomas R, Sanders S, Doust J, Beller E, Glasziou P (2015) Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics 135:e994–e1001

    Article  PubMed  Google Scholar 

  14. Marshall RM, Hynd GW, Handwerk MJ, Hall J (1997) Academic underachievement in ADHD subtypes. J Learn Disabil 30:635–642

    Article  PubMed  CAS  Google Scholar 

  15. Barry TD, Lyman RD, Klinger LG (2002) Academic underachievement and attention-deficit/hyperactivity disorder: the negative impact of symptom severity on school performance. J School Psychol 40:259–283

    Article  Google Scholar 

  16. ACT (2007) The role of nonacademic factors in college readiness and success. Iowa City, IA. http://www.act.org/content/act/en/research/pdfs/the-role-of-nonacademicfactorsincollegereadinessandsuccess.html. Accessed 12 Nov 2017

  17. Rosenkranz J, Bonzel KE, Bulla M, Michalk D, Offner G, Reichwald-Klugger E, Scharer K (1992) Psychosocial adaptation of children and adolescents with chronic renal failure. Pediatr Nephrol 6:459–463

    Article  PubMed  CAS  Google Scholar 

  18. Qvist E, Pihko H, Fagerudd P, Valanne L, Lamminranta S, Karikoski J, Sainio K, Ronnholm K, Jalanko H, Holmberg C (2002) Neurodevelopmental outcome in high-risk patients after renal transplantation in early childhood. Pediatr Transplant 6:53–62

    Article  PubMed  Google Scholar 

  19. Warady BA, Belden B, Kohaut E (1999) Neurodevelopmental outcome of children initiating peritoneal dialysis in early infancy. Pediatr Nephrol 13:759–765

    Article  PubMed  CAS  Google Scholar 

  20. Ehrich JH, Rizzoni G, Broyer M, Brunner FP, Brynger H, Fassbinder W, Geerlings W, Selwood NH, Tufveson G, Wing AJ (1992) Rehabilitation of young adults during renal replacement therapy in Europe. 2. Schooling, employment, and social situation. Nephrol Dial Transplant 7:579–586

    Article  PubMed  CAS  Google Scholar 

  21. Ryan CL, Bauman K (2016) Educational attainment in the United States: 2015 population characteristics. United States Census Bureau, 2015 Current Population Survey (CPS) Annual Social and Economic Supplement (ASEC). https://www.census.gov/content/dam/Census/library/publications/2016/.../p20-578.pdf. Accessed 8 Oct 2018

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Acknowledgements

Data in this manuscript were collected by the CKiD prospective cohort study (CKiD) with clinical coordinating centers (Principal Investigators) at Children’s Mercy Hospital and the University of Missouri—Kansas City (Bradley Warady, MD) and Children’s Hospital of Philadelphia (Susan Furth, MD, PhD), Central Biochemistry Laboratory (George Schwartz, MD) at the University of Rochester Medical Center, and data coordinating center (Alvaro Muñoz, PhD) at the Johns Hopkins Bloomberg School of Public Health. The CKID website is located at http://www.statepi.jhsph.edu/ckid.

Funding

CKiD is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute (U01-DK-66143, U01-DK-66174, U01DK-082194, U01-DK-66116). Dr. Harshman is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (1K23DK110443-01).

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Dialysis and Transplantation, University of Iowa Stead Family Department of Pediatrics, 4037 Boyd Tower, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Lyndsay A. Harshman

  2. Division of Developmental and Behavioral Sciences, Children’s Mercy Kansas City, Kansas City, MO, USA

    Rebecca J. Johnson

  3. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Matthew B. Matheson

  4. Division of Nephrology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Amy J. Kogon & Susan L. Furth

  5. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Amy J. Kogon & Susan L. Furth

  6. Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Shlomo Shinnar

  7. Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Shlomo Shinnar

  8. Department of Epidemiology and Population Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Shlomo Shinnar

  9. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Arlene C. Gerson

  10. Division of Pediatric Nephrology, Children’s Mercy Kansas City, Kansas City, MO, USA

    Bradley A. Warady

  11. Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Stephen R. Hooper

Authors
  1. Lyndsay A. Harshman
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  2. Rebecca J. Johnson
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  3. Matthew B. Matheson
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  4. Amy J. Kogon
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  7. Bradley A. Warady
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  8. Susan L. Furth
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  9. Stephen R. Hooper
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Corresponding author

Correspondence to Lyndsay A. Harshman.

Ethics declarations

The CKiD protocol received approval from the Institutional Review Boards at each center.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Cite this article

Harshman, L.A., Johnson, R.J., Matheson, M.B. et al. Academic achievement in children with chronic kidney disease: a report from the CKiD cohort. Pediatr Nephrol 34, 689–696 (2019). https://doi.org/10.1007/s00467-018-4144-7

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  • DOI: https://doi.org/10.1007/s00467-018-4144-7

Keywords

  • Academic achievement
  • Pediatric
  • Chronic kidney disease